Preferred Savings Network(1)


HealthCare Advantage is innovating the medical discount services industry by building an exclusive provider network for our members. The Preferred Savings Network is designed to meet the specific needs of uninsured and underinsured Americans by providing HealthCare Advantage members with simple, predictable medical fees rather than percentage discounts.

Depending on your location, HealthCare Advantage may have participating physicians available for you and your family at fixed affordable rates. The Preferred Savings Network reduces the cost of physician office visits for our members by up to 60%. You receive your savings on the date of service and there are no claim forms to file for reimbursement.

In order for providers to participate in our network, they must be credentialed. We then negotiate contracts with providers on a national basis to provide care for HealthCare Advantage members at reduced rates. Delivering these choices empowers you with the information and knowledge you need to make the right decisions for your healthcare needs.

All Hospital services require pre-certification and proof of ability to pay and/or a down payment in order to qualify for discounted hospital services.

 Note to Maryland residents: Discount benefits are not available at Maryland hospitals and acute care centers.

 

National Savings Network(1)


The National Savings Network allows members to access the same networks that employees of large companies have been enjoying for years through their group health insurance. Through HealthCare Advantage’s network of more than 400,000 providers, members can enjoy savings up to 50% off usual and customary charges. To ensure you achieve maximum savings, our Customer Service Representatives assist you in selecting participating providers based on specialty, location and cost. Although charges vary from one provider to the next, savings are immediate and there are no claim forms to file for reimbursement.

All Hospital services require pre-certification and proof of ability to pay and/or a down payment in order to qualify for discounted hospital services.

Note to Maryland residents: Discount benefits are not available at Maryland hospitals and acute care centers.

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Physician Visit Reimbursement


Our members with Advantage Preferred Packages or the Advantage Physician Visit benefit will be reimbursed up to the benefit limit for visits to the physician of your choice. Although you may go to any doctor to receive coverage under this benefit, your out-of-pocket expense will be minimized by first calling HealthCare Advantage Customer Service so that we can assist you in identifying a physician in your area.

This benefits will pay you according to the following benefit schedule
 
Adv I & II Preferred
Adv III & IV Preferred
 
$20 Physician Visit
$30 Physician Visit
Physician Office Visit:
Benefit Pays You
$20 per visit
Benefit Pays
You $30 per visit
 
Maximum # of visits per year:
Single
4
4
Family
6
8

Example: A member visits Physician in the PSN Network who charges $40 for the visit. The member pays $40 at the time of the visit and submits a claim.

The member is then reimbursed $30 reducing the total cost to $10.

These benefits apply for any physician regardless of network participation.

Limitations/Termination: The maximum number of visits for any individual member under Family coverage is limited to four visits per year.  The Benefits are subject to a 30-day waiting period from your initial membership date with Healthcare Advantage. Only HealthCare Advantage members are eligible for this coverage. Eligible dependents include the member’s lawful spouse and children under age 19 years of age, or 25 if full-time students. This coverage will automatically terminate when member terminates membership or when membership becomes inactive for non-payment.
Exclusions: Benefits will not be payable for visits that are the result of the following: (a) Elective treatment where no injury or sickness is involved; (b) Dental care or treatment except due to injury; (c) Expenses for nervous or mental disease or disorders; or alcoholism or drug addiction; (d)Intentionally self-inflicted injury, suicide or any attempt thereat.  (In Missouri this applies only while sane.); (e) Commission or attempt to commit a felony; (f) Participation in a riot or insurrection; (g) Driving while intoxicated or under the influence of a controlled substance unless administered on the advice of a doctor; (h) Declared or undeclared war or act of war; or (i) While the covered person is on the active duty service in any Armed Forces.  Benefits will not be payable for wellness-only visits.

Please mail your claim to:

Health Network America /
Triveris

P.O. Box 307
Eatontown, NJ 07724

Be sure to include:

  1. Itemized Bill from your physician
  2. Name of the Patient and Primary Member
  3. HealthCare Advantage, Member ID Number
  4. Phone Number
If you have questions regarding your claim for your physician office visit, please contact HNA at::
Toll Free:
(800) 790-3258
To obtain claim forms, please click here:

 Physician Visit Reimursement  |  AD & D  |  Disability
*Underwritten by Fairmont Premier Company or Fairmont Specialty Insurance Company
This summary is not the policy.  This policy is on file with Healthcare Advantage.

 

Dental Plan(2)

Members enjoy savings of 30 - 50% or more on all dental procedures with more than 13,000 dental providers nationwide. Members may use the program as often as they need without worrying about annual maximums, waiting periods or being declined for treatment of ongoing medical conditions.

In fact, utilizing this benefit is extremely easy. As a member, you would choose a dentist from our list of participating dentists and make an appointment. When you arrive at your appointment, you would inform them that you are a Healthcare Advantage member and present them with your card. The dentist will provide you with the services needed and charge you the reduced rates according to the fee schedule. It's that easy!

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Vision Plan(2)

Members are offered 10% to 60% discounts on eyeglasses and other retail eyewear through a network of over 10,000 vision professionals nationwide. The best thing of all is that since the Vision Plan is not insurance, there are no claim forms to file and no waiting periods! Most frames, lenses, and specialty items such as tints, scratch resistant coatings, and ultraviolet protection are available. There is no limit to eyewear selection or the number of times you and your family may use the membership during the year. Optometric exam fees are discounted at some locations.

Ophthalmologists in select markets provide members with 10% to 30% off eye exams and surgical procedures, including RK, PRK, ALK and Lasik surgery where available.

 

Contact Lenses

Members enjoy a savings of 20% - 60% on many major brands of soft contact lenses including disposable, torics and bifocals. Gas permeable lenses are also available.

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Chiropractic Network(2)

Members may access our nationwide network of over 3,000 providers and receive savings up to 50% off usual and customary charges.

 

National Retail Pharmacy


If you are paying too much for your prescription medication, we can help. Members receive savings of up to 40% through our nationwide network of pharmacies.

Please call (800) 290-3607 to locate a participating pharmacy.

A partial listing of participating pharmacies include:
CVS 
Walgreens
Shop-Rite
Costco		 Publix Pharmacy
Winn-Dixie
Phar-mor
Grand Union		 Rite-Aid
K-Mart
Savmor
Stop & Shop		 Drug Emporium
Target Stores
Navarro

*Pharmacies are subject to change without notice

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Mail-Order Pharmacy

Members have access to incredible savings by ordering maintenance prescriptions through our online Mail-Order Pharmacy. Our members' safety is always paramount. To that end, the information system that manages our on-line pharmacy carefully monitors member health profiles for drug interactions, allergies, potential complications and unusual dosage. This service is ideal for those using maintenance drugs and best savings are received when ordering a 90-day supply. To obtain pricing Click Here or please call (877) 278-5387.

 

Elder Care(2)

Are you worried about long term care for an aging loved one? Call Nurse Navigator to get discounts and referrals to over 6,000 providers and 4,000 geriatric care managers nationwide. Our network of providers are all screened and credentialed to ensure your loved one receives quality care.

New patients save up to 25% on home health aides, nursing homes, assisted living facilities, Alzheimer's special care units, and respite care facilities. Savings can also be accessed on geriatric care management services such as telephone check-in, elder assessments, and care plans. Geriatric care managers are professionals who are experts at advising families and coordinating care for the elderly.

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Hearing Care Plan(2)

Members can access a network of over 1,200 Beltone independent locations nationwide and receive savings up to 15% on hearing aides, along with a free hearing screening.

Plus…Up to 50% off audiology and hearing aide services at over 1,400 participating Hear PO providers.

By utilizing our Mail Order program, members can also save up to 60% off retail on over 80 models of major brand name hearing instruments, along with a 30-day home trial period and one year factory warranty.

 

Emergency Travel Assistance(3)

We offer the world’s premiere emergency travel assistance program. If a member is ever ill or injured while traveling more than 100 miles away from home and they cannot be treated at a local medical facility, they have access to the Emergency Evacuation Repatriation. This benefit offers transportation by the most appropriate means to the nearest hospital capable of providing necessary treatment. This unique feature eliminates the adverse effect of the “cash before boarding” policy of most carriers. This benefit is not available in California

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24-Hour Nurse Hotline


As a member, you and your dependents will have unlimited access to registered nurses via a toll-free number. These nurses are specially trained to offer prompt, confidential medical counseling to help you make informed decisions about your family's health and medical care. However, nurses will not diagnose or provide treatment.

You can receive information regarding:

  •  Treating common illnesses
  •  Explanations as to what to expect during medical testing
  •  Diagnostic and surgical procedures
  •  Recently diagnosed medical conditions
  •  Prescription and over the counter medication information

This service can help you become more knowledgeable about healthcare services and more comfortable working in partnership with your healthcare providers.

 

24-Hour Counseling Hotline

This service provides unlimited telephone counseling services 24 hours a day, 365 days a year at no cost.

Counseling may be provided for:

  •  Emotional Distress
  •  Work-Related Stress
  •  Marital Discord
  •  Child Abuse
  •  Grief and Loss
  •  Substance Abuse
  •  Parenting Challenge
  •  Financial Worries
  •  Anxiety
  •  Depression
  •  And many more…

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Fitness Membership

Up to 50% Off Membership Dues at over 1,500 locations Nationwide, including many franchise and independent fitness clubs such as Gold's Gym, Bally Total Fitness, Curves for Women,World Gym and more. HealthCare Advantage Members can enjoy the benefits of fitness and exercise with significant savings on monthly fees without the burden of annual contracts.

 

Vitamins & Supplements

The vitamin program is designed to help you maintain excellent health. This benefit provides you with the health products you need at the lowest possible price...thus helping you to maintain positive financial health as well!

Members receive:

• Receive reliable health information from medical doctors.
• Receive a money back guarantee on orders.
• Most items are in stock and shipped the same day.

  • Save between 43-85%* off retail prices on more than 6000 vitamins, supplements,
    low carb and skin care items.     *With additional 10% member discount.

How to Access this Benefit:

1. Call 1-888-848-2329 to place an order with extensive savings on Vitamins, supplements and skin care items or visit www.VitaCost.com to complete your order online.

2. Mention # BD060410 to receive your extra 10% discount on vitamins, supplements, and skin care items. 10% discount savings.

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Medical Records Plus Software Click Here for Access

In a medical emergency, time is of the essence.  Using state-of-the-art technology, Medical Records Plus can release your confidential health information, including medical conditions, allergies, insurance data, treatments, immunizations, medications, physician information, emergency contact information, advance directives and more. Additionally, Medical Records Plus call center is staffed with qualified nurses. You can even transfer records to new doctors, specialists, school or camp without filling out tedious paperwork!

Medical Records Plus is the personal medical records solution that gives you fast, secure telephone access to your complete medical records, whenever you need them. Medical Records Plus professionally maintains your vital medical information and releases them to healthcare providers within minutes of your call. Medical Records Plus has a complete system of security controls, including a personal identification number, to ensure that records are released only with your authorization. With Medical Records Plus, you determine what information is shared and with whom.

Click Here for Access

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Durable Medical Equipment& Supplies


Advantage Preferred members save 25% off Durable Medical Equipment (DME) and Supplies. This benefit covers a range of both hard and soft medical items including:

Members receive:

  •  Shower chairs
  •  Wheelchairs
  •  Canes
  •  Walkers
  •  Lift chairs
  •  Hospital beds
  •  Surgical supplies such as bandages, IV tubing & needles
  •  Diabetic products such as testing strips
  •  Ostomy care products
  •  Respiratory supplies such as oxygen canisters, oxygen, respirators,
     C-Pap machines and nebulizers

 Procedure to Access DME Discounted Providers:

Contact the Customer Service Center at 1-877-275-1010 and mention group # 101.  The member will be asked to describe their needs.  The Customer Service Rep will contact several providers to determine the best available price and give this information to the member for them to follow up with the provider directly.  If requested by the member, a nurse navigator will arrange for the supplies on behalf of the member. Supplies will be delivered directly to your home.

 

Alternative Medicine Plan(2)


The Alternative Medicine Network is one of the nation's leading providers of integrative medicine. This national network of over 10,000 practitioners provides alternative medicine to millions of members all across the country. The integration of alternative medicine into conventional western medicine is quickly revolutionizing the landscape of the American healthcare system.

Practitioner Disciplines:

  •  Acupuncturists
  •  Massage Therapists
  •  Nutritional Counselors
  •  Holistic Physicians
  •  Reflexology, meditation and relaxation technique practitioners
  •  And many more...

Features:

  •  Up to 30% savings on all treatments and services
  •  Over 10,000 participating practitioners nationwide
  •  Over 33 different practitioner disciplines
  •  No limits on the number of visits

Note: Available for the Advantage II, III and IV plans only.

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Fixed Rate Dental(2)

Advantage I and II members Save 20 - 30% on Dental procedures. Advantage III, IV and RX Plus plan members enjoy Savings of 30 - 50% on dental procedures and the added benefit of having a Fixed Rate Dental Plan that has no deductibles, no claim forms, no waiting periods and no limitation on usage because the plan is not insurance.

Our Fixed Rate Dental Plan offers a:

Our Fixed Rate Dental Plan offers a:
Comprehensive oral exam for no charge* | Complete series of x-rays at no charge*

*Provided once annually by Participating General Practitioner in Schedule A network. This program is not insurance and is not available in all areas. Reduced fees on serves are not available where prohibited by law.

Examples of Dental Savings:
Procedure
UCR
Member
Savings($)
Savings %
Complete Series of X-Ray Films
$110
No Charge
$110
100%
Filling, I Surface Permanent
$109
$45
$64
58%
Root Canal, Molar
$850
$385
$465
65%
Full Denture Upper or Lower
$1.400
$560
$840
60%
Orthodontics
$4,969
$3,000
$1,969
40%
*Provided once annually by Participating General Practitioner in Schedule A network. This program is not insurance and is not available in all areas. Reduced fees on serves are not available where prohibited by law.

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Fixed Rate Vision(2)


Advantage III, IV and RX Plus plan members enjoy the added benefit of having a Fixed Rate Vision Plan that has no deductibles, no claim forms, no waiting periods and no limitation on usage because the plan is not insurance.

Our Fixed Rate Vision Plan offers each family member an annual no charge comprehensive eye exam and follow-up visits at a cost of only $20.00.

Members also enjoy saving of up to 50% off the following:

  •  Laser Vision Correction
  •  Eyeglasses
  •  Standard Polycarbonate
  •  Contact Lenses
  •  Standard Scratch Resistance
  •  Fashion Frames
  •  Standard Anti-Reflective
  •  Designer Sunglasses
  •  Tints, UV Coatings, Supplies
  •  Eyecare Solutions and More

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Fixed Rate Chiropractic(2)


Healthcare Advantage III, IV and RX Plus plan member enjoy a Fixed Chiropractic Plan that has office visits for $35.00, which includes two examinations and X-rays.

Other plan features include:

  • Adjustments (children up to 18)  $10.00
  • Adjustments (adult)    $20.00
  • One Adjunctive Therapy  $12.00
  • Additional Adjunctive Therapy  $ 6.00

Examinations include Chiropractic & Postural; Orthopedic-Neurological.

The X-rays include 2 Views of Spine when necessary.

 

Four Tier Prescription Drug Fixed-Pay Plan

Prescription Drug Fixed-Pay Plan members are provided with a Fixed Rate RX member guidebook which contains a list of generic and brand name drugs that are listed on each of the three Tiers. Many more prescriptions are included in Tiers 1, 2 and 3 than are listed in the member guidebook. To verify which Tier your drug is listed on, you may click here or contact our pharmacy customer service directly at 1-800-290-3607.

Your Fixed Rate Prescription Plan works on a 4 Tier basis

Maximum cost for Generic & Brand drugs listed in the Fixed Rate RX Member Guidebook are:

  •  Tier 1: up to $10.00
  •  Tier 2: up to $20.00
  •  Tier 3: up to $50.00
  •  Tier 4: All other Drugs which do not fall under Tier 1, Tier 2 or Tier 3 are available for your benefit at specially  negotiated rates.

This plan may be purchased as an optional benefit for the Advantage I, II and III plan memberships. Advantage IV plan and Advantage RX Plus memberships include the Four Tier Prescription Drug Fixed-Pay Plan.

Four Tier - Prescription Drug Fixed-Pay Plan Rates
Monthly Fee:
Plan
Adv I
Adv II
Adv III
Adv IV
Adv RX
Single
$25.00
$25.00
$25.00
Included
Included
Family
$35.00
$35.00
$35.00
Included
Included
One Time Processing Fee $25.00

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Diabetic Supplies Benefit


Diabetic-Service Website Main Page: www.diabetic-service.com or Call: (866) 592-3330 for assistance

Included in Advantage IV Preferred, Advantage RX Plus, and any plan where the member purchased optional Fixed Rate Prescription

Prescription Drug Fixed Pay Plan members receive access to a Diabetic Supply program with their prescription card.

This program provides special member pricing on non-prescription diabetic supplies and medication.

Examples of Supplies:  Test strips, Meters, Lancets, Insulin, and Syringes

   300 Elite Strips Elite XL Meter $185.90
   300 Free Style Test Strips & 1 Free Meter    $165.71
   300 Prestige Strips and a Free Meter   $114.13


The member may also purchase sugar-free foods, clothing, cold medicine, personal care items and other accessories at a discount.

  • This a mail order only program.
  • There is no standard shipping and handling charges.
  • Orders can be taken either over the phone through a toll-free number or on-line via a website.

Using the toll-free number: (866) 592-3330

  1. The member must identify themselves as a HealthCare Advantage member and supply the representative with their HealthCare Advantage Member ID number.

    Note: At times, the member may be asked to leave a message and a representative will return their call.  Phone calls are returned by Diabetic-Service.com within 24 hours of receipt.
  2. The member must also provide their name, billing address, shipping address and telephone number.
  3. Once an order has been placed, the member must provide a method of payment. Payment methods can be one of the following Visa, MasterCard, American Express, Discover, Check or Money Order.
    • When placing an order using a credit card the member must provide a valid credit card number, security code and expiration date.
    • When placing an order using a check, the check must be received by Diabetic-Service.com before the order is shipped to the member.
  4. The member will also need to chose a shipping method, which includes one of the following:
     Options
    $0.00 - $249.99
    $250.00 +
    Delivery Time
     Standard
    Free
    Free
    4 – 7 Days
     3rd Business Day
    $2.00
    $9.95
    3 Days
     2nd Business Day
    $8.00
    $15.95
    2 Days
     Next-Business Day
    $11.00
    $18.00
    1 Day
  5. Once the order is complete, the member will be provided with a confirmation number.

Using the Website:

The member will need to visit www.diabetic-service.com.

In the User Name field (the first box), the member needs to enter their HealthCare Advantage Member ID.

In order to use the Diabetic-Service.com website, the member must log in using their HealthCare Advantage Member ID.

In the Password field (the second box), the member needs to enter the word ‘glucose’ in lower-case letters.

After logging in successfully, members will receive the Billing/Shipping Information Screen.  If this is the member’s first visit to the website, they must do the following:

Verify their Billing/Shipping Information is correct.  If necessary, correct any information and click Update. Change their password from ‘glucose’ to a password of their choice. 

The password can be changed by clicking on “Click Here to Change Your Password”.  The password can be any combination of letters or numbers and it must be at least three characters in length.

The member may shop on-line by clicking on “Click Here to Shop”.

The member may select Diabetic Supplies, Sugar Free Foods, Cold Medicine, Diabetic Apparel or Personal Care and begin shopping.

Once the member has finished shopping, they will need to:

Confirm their Billing/Shipping Information.

Review their Order Summary and Order Total.  If applicable, enter a promotional code.

Enter a payment method from one of the following: Visa, MasterCard, American Express, Discover, Check or Money Order.

When placing an order using a credit card the member must provide a valid credit card number, security code and expiration date.

When placing an order using a check, the check must be received by Diabetic-Service.com before the order is shipped to the member.

Once the payment information has been submitted, the member will receive an Order Confirmation Screen, which includes the date of the order, confirmation number, order number, order summary and order total.

The member can view the Order Status on-line at:  www.diabetic-service.com/orderstatus.asp

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Accident Medical/Dental Benefits


In the event of an accident, the primary member, their spouse and immediate family members are protected under this plan. If the Insured's injuries result in medical expenses, after the plan deductible of $100, the insurance company will pay (up to the maximum offered under the Advantage Plan) for necessary medical treatment at the usual and customary charge for such expense.

The overall maximum benefit amount for each Advantage Plan is as follows:

Download | Claim Form


Advantage Plan Maximum Benefit Amount

Advantage I

$1,500

Advantage II

$2,500

Advantage III

$4,000

Advantage IV

$5,000
*The payout varies per plan.


Members enjoy:

  •  24-hour coverage/7 Days a Week
  •  The ability to go to any doctor, hospital or medical facility
  •  Worldwide protection
*Underwritten by Fairmont Premier Company or Fairmont Specialty Insurance Company
This summary is not the policy.  This policy is on file with Healthcare Advantage.

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Accidental Death and Dismemberment Benefit


In the event of an accident in which death or dismemberment occurs, members under the age of 70 and their immediate family members under the age of 70 are protected under this plan. An injury must happen while the member’s coverage under the program is in force and when the accident directly and independently causes a loss of life or limb.

  •  24-hour coverage/7 Days a Week
  •  Any doctor, hospital or medical facility
  •  Worldwide protection

Download | Claim Form


Advantage Plan Principal Amount

Advantage I

$5,000

Advantage II

$10,000

Advantage III

$15,000

Advantage IV

$25,000
*The payout varies per plan.

 

*Underwritten by Fairmont Premier Company or Fairmont Specialty Insurance Company
This summary is not the policy.  This policy is on file with Healthcare Advantage.

 

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Weekly Disability Income Benefit 


As an Advantage III or IV member, if the primary member becomes totally disabled, unable to perform the substantial and material duties of their regular job and are under the care of a doctor they may be eligible to receive the weekly disability benefit.

This benefit offers:

  • 24-hour coverage/7 Days a Week
  • Elimination Period of 14 days
  • Benefits paid out weekly
  • Maximum payout is 26 weeks.
 Download | Claim Form

If, as a result of injury, a member becomes totally disabled within 30 days from the date of the accident, the insurance company will pay 70% of the basic weekly salary amount, subject to a maximum of $100.00 per week for Advantage III and $200.00 per week for Advantage IV. Total disability means the member is unable to perform the material and substantial duties of an occupation for which the insured is qualified by education, training or experience.

After a 14-day elimination period, this benefit begins on the 15th days from the start of the continuous disability. The insurance company will pay this benefit for as long as the member is disabled from any one accident, but for no longer than the maximum of 26 weeks.

Advantage Plan Coverage Amount

Advantage III

up to $100 /week for 26 weeks

Advantage IV

up to $200 /week for 26 weeks

*Underwritten by Fairmont Premier Company or Fairmont Specialty Insurance Company
This summary is not the policy.  This policy is on file with Healthcare Advantage.

(1) These Membership Benefits are not available in CA, FL, ND or TX.

(2) These Membership features are discount program features provided by Patriot Health Florida, Inc.* The Patriot Health Florida, Inc.* program is not a health insurance policy and is not intended as a substitute for insurance. The program provides for discounts on health services from participating providers, and the range of the discounts will vary depending on the type of provider and the health services received. The program does not make payments to providers of health care services. Members are required to pay for all health care services at the time the services are performed, but will receive a discount from contracted providers. This program is administered by Patriot Health Florida, Inc., at 160 Eileen Way • Syosset, NY, 11791, and is offered to members of Consumer Health Choice Association, located at 8201 Peters Road Suite 1000, Plantation, FL 33324.

The Patriot Health Florida, Inc. program features are not available in CA, CT, FL, ID, KS, ME, MT, ND, NH, NV, OK, VT and WA

(3) Emergency Travel Assistance is not available in CA, FL or NY.

 

© All Rights Reserved 2005 HEALTHCARE ADVANTAGE, LLC
861 S.W. 78th Avenue • Suite 200 • Plantation, FL 33324 • PH: 954.453.7450 • FAX: 954.453.7709

This Benefit Plan is neither insurance nor a health insurance policy. The plan provides for discounts on health care services from participating providers only. The plan does not make payments to providers. The member is responsible for paying for all health care services, but will receive a discount from participating providers contracted with HealthCare Advantage.

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